Postcoital bleeding

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Postcoital bleeding
Gynecology

Postcoital bleeding (PCB) is non-

vaginal bleeding that occurs during or after sexual intercourse.[1] Though some causes are with associated pain, it is typically painless and frequently associated with intermenstrual bleeding.[2][3]

The bleeding can be from the uterus, cervix, vagina and other tissue or organs located near the vagina.[4] Postcoital bleeding can be one of the first indications of cervical cancer.[5][6] There are other reasons why vaginal bleeding may occur after intercourse. Some people will bleed after intercourse for the first time but others will not. The hymen may bleed if it is stretched since it is thin tissue. Other activities may have an effect on the vagina such as sports and tampon use.[7] Postcoital bleeding may stop without treatment.[8] In some instances, postcoital bleeding may resemble menstrual irregularities.[9] Postcoital bleeding may occur throughout pregnancy. The presence of cervical polyps may result in postcoital bleeding during pregnancy because the tissue of the polyps is more easily damaged.[10] Postcoital bleeding can be due to trauma after consensual and non-consensual sexual intercourse.[11][4]

A diagnosis to determine the cause will include obtaining a medical history and assessing the symptoms. Treatment is not always necessary.[12]

Causes

Vaginal bleeding after sex is a symptom that can indicate:

Bleeding from hemorrhoids and vulvar lesions can be mistaken for postcoital bleeding.

birth control pills may cause postcoital bleeding.[6]

Risk factors for developing postcoital bleeding are: low estrogen levels, rape and 'rough sex'.[4]

Diagnosis and treatment

Tests and detailed examination are used to determine the cause of the bleeding:

A referral may be made to a specialist.[12][16] Imaging may not be necessary. Cryotherapy has been used but is not recommended.[4]

Epidemiology

Postcoital bleeding rarely is associated with gynecological cancer in young women and its incidence is projected to drop due to the widespread

Benign causes of postcoital bleeding were associated with cervical erosion, ectropion, vaginitis and vulvovaginitis. Other associations were noted such as the presence of leukoplakia of the cervix, an intrauterine contraceptive device, cervical polyps, cervicitis, menopause, dyspareunia, and vulvodynia.[17] In Scotland approximately 1 in 600 women aged 20–24 experience unexplained bleeding.[6] A study of African women found that trauma from consensual sexual intercourse was a cause of postcoital bleeding in young women.[3]

In society and culture

Hymenorrhaphy is a controversial procedure to surgically repair a damaged hymen, thus restoring the appearance of virginity:

"From a Western-ethics perspective, the life-saving potential of the procedure is weighed against the role of the surgeon in directly assisting in a deception and in indirectly promoting cultural practices of sexual inequality. From an Islamic bioethical vantage point, jurists offer two opinions. The first is that the surgery is always impermissible. The second is that although the surgery is generally impermissible, it can become licit when the risks of not having postcoital bleeding harm are sufficiently great."[18]

See also

References

  1. PMID 37696551
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  2. ISBN 978-0-443-10739-9
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  3. ^
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  5. PMID 16762128
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  6. ^ a b c Health, Department of (2010-03-03). "Clinical practice guidelines for the assessment of young women aged 20-24 with abnormal vaginal bleeding". Archived from the original on 2010-11-10. Retrieved 2018-02-04.{{cite web}}: CS1 maint: bot: original URL status unknown (link)
  7. ^ Choices, N. H. S. (2016-07-12). "Does a woman always bleed when she has sex for the first time? - Health questions - NHS Choices". Retrieved 2018-02-04.
  8. S2CID 25418515
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  9. PMID 25259677
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  10. OCLC 841914663.{{cite book}}: CS1 maint: multiple names: authors list (link
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  11. PMID 27279958
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  12. ^ a b c d e f g h Choices, N. H. S. (2018). "What causes a woman to bleed after sex? - Health questions - NHS Choices". Retrieved 2018-02-04.
  13. ^ a b c d "Postcoital Bleeding in a Premenopausal Patient". www.medscape.com. Archived from the original on 2002-04-15. Retrieved 2018-02-04.
  14. ISBN 9780702051036
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  15. ISBN 978-0702040917
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  16. ^ "Postcoital bleeding". Royal College of Obstetricians & Gynaecologists. Archived from the original on 2020-01-28. Retrieved 2018-02-05.
  17. S2CID 8994475
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  18. PMID 28760245
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